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Immunoglobulin A Nephropathy Secondary to Wilson's Disease: A Case Report and Literature Review

Yoshinosuke Shimamura, Takuto Maeda, Yufu Gocho, Yayoi Ogawa, Kunihiko Tsuji, Hideki Takizawa

CEN Case Rep. 2019 Feb;8(1):61-66.

PMID: 30255238

Abstract:

Immunoglobulin A nephropathy is the most common primary glomerulonephritis worldwide, and it can be associated with liver disease. However, cases of Immunoglobulin A nephropathy secondary to Wilson's disease are very rare. A 20-year-old Japanese man presented with microscopic hematuria, proteinuria, and renal dysfunction. A renal biopsy showed mesangial cell proliferation, immunoglobulin A deposition, and electron-dense deposit in the mesangial areas, all of which are consistent with Immunoglobulin A nephropathy. Computed tomography of the abdomen showed liver atrophy and splenomegaly, and the diagnosis of Wilson's disease was confirmed with decreased serum ceruloplasmin levels, increased urinary copper excretion, Kayser-Fleischer rings and copper deposition in the liver biopsy. The patient was treated successfully with trientine hydrochloride and zinc acetate and showed improvement in renal manifestations. Wilson's disease is a rare cause of secondary Immunoglobulin A nephropathy. We recommend that Wilson's disease should be considered the cause of secondary Immunoglobulin A nephropathy in juvenile patients with hematuria, proteinuria, and splenomegaly and suggest measuring the serum ceruloplasmin concentrations, urinary copper excretion, and evaluating Kayser-Fleischer rings in these patients.

Chemicals Related in the Paper:

Catalog Number Product Name Structure CAS Number Price
AP38260014-A Trientine hydrochloride Trientine hydrochloride 38260-01-4 Price
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